The Bangladesh Paradox: exceptional health and sanitation advances despite poverty

Dr. Mushtaque Chowdhury from BRAC on the Bangladesh public health miracle, aid or trade, arsenic, floating latrines and the post-2015 development agenda.

Dr. Mushtaque Chowdhury from BRAC presents the “Bangladesh Paradox”, International Water House, The Hague, The Netherlands, 30 July 2014

By Cor Dietvorst and Vera van der Grift, IRC
Originally posted on the IRC web site, 01 August 2014

Bangladesh has made tremendous progress in the fields of health and sanitation. With a population of 149 million, it now has the highest life expectancy; the lowest fertility rate and the lowest mortality rate of children under five in South Asia (excepting Sri Lanka), although it spends less on health care than most neighbouring countries. Only 10% of the population in Bangladesh practices Open Defecation (OD) compared to 50% in India.

It is one of only six countries that are on track to achieve Millennium Development Goals 4 and 5 on reducing child mortality and improving maternal health.

Emerging from the war of liberation in 1971, Bangladesh embraced a new more liberal identity, which manifested itself in a change in societal attitudes towards women, and girls’ education in particular.

Thailand: floating toilets for flood-hit areas

Photo Bangkok Post

As Thailand faces its worst flooding in more than 50 years, a local company is distributing floating toilets free of charge to government offices.

Cotto, part of Siam Cement Group (SCG), designed the floating twin-toilet unit, which weighs 800 kg. It has one modern toilet and one Thai-style pour-flush toilet.

Cambodia: Floating Toilets for Floating Villages

Mr. Sahari Ani, Photo: ADB

Mr. Sahari Ani, the CEO of Lien Aid, a Singapore-based nongovernment organization, was interviewed by the Asian Development Bank in their “Water Champion” series. Mr Ani spoke about his organisation’s work in Cambodia, in particular on the floating toilets of the “River of life” project (see also an earlier blog post on this project). “With this, we hope to provide better sanitation options for the floating communities on the Tonle Sap [lake]. We’ve already heightened the communities’ awareness on proper sanitation. This month, we will introduce different toilet designs that they can build on their houseboats. Simultaneously, we’re providing them with a safer choice for drinking water by building a floating water treatment plant” Mr. Ani said. “We are exploring several options including the use of especially adapted septic tanks plus ecological sanitation using the urine diversion-dissecting (UDD) toilet”.

Based on the villagers’ preferences, Lien Aid “determined the size of the toilets, buckets to be used for storage of excreta, ecosan pans (2-hole or 3-hole), and other design considerations [resulting in] 3 workable designs to date”. “Our next challenges are to modify existing toilets to incorporate the UDD options, ensure availability of suitable drying material for covering feces, and keep the costs manageable”, Mr. Ani explained.

Lien Aid, which works together with the Ministry of Rural Development (MRD) and local authorities, “is developing simple […] publications on methods of construction, use, and maintenance of the floating toilets”.

Floating toilets cost “between US$50-200, depending on whether the family will just upgrade their existing drop-hole toilet to accommodate the UDD technology or whether the entire toilet, including superstructure, will be constructed from scratch. The size of the toilet will also dictate the cost – toilets that can accommodate 2 tanks will obviously cost more. We’re still trying to lower the cost by using indigenous materials and encouraging local entrepreneurs to manufacture the UDD pans”.

Together with the floating toilets, “a land-based composting unit and collection system will be established to manage the semi-composted feces. We hope to promote the use of fully decomposed feces as compost”.

Lien Aid had “already set up a community center for water-sanitation related training and advocacy activities” and “will also form a water-sanitation group from among the residents and community leaders”.

“Our work is less about giving hand-outs and more about empowering people to participate and make informed choices on how they can improve their lives. Extensive consultation with local authorities, NGOs, and communities is the backbone of our work”.

See sample designs of floating UDD toilets here.

Source: ADB, Feb 2009

Cambodia: Singaporean group introduces “floating” toilets

In rural Cambodia, only 16 per cent of residents have a proper toilet — the lowest rate in Southeast Asia.

Floating house with outside toilet. Photo: Channelnews.com

[…] On Cambodia’s great lake, Tonle Sap […] homes are floating platforms and must move seasonally, and outhouses are simply a wooden plank over the open water. People have no choice but to contaminate the very same water they use for drinking and washing.

[The “River of Life” project launched by Singaporean NGO Lien Aid and the Lien Institute For the Environment (LIFE)], aims to make a difference in this community of about 10,000 people [by] introducing the concept of “floating” toilets which are affordable, locally-made, and therefore sustainable.

“It is actually a simple system… We’re going to use locally available buckets where they can collect the faeces. We are going to use some locally available agent to dry the faeces, that is, using ashes and other local material,” said the CEO of Lien Aid, Sahari Ani.

One key to the project is that locals will have to source and build their own toilets, to ensure that all parts of the community are involved.

“The toilet that we introduce to the community — they are very happy to get that one and they try to find their own resources to contribute to the project,” said the director of the Department of Rural Health Care, Ministry of Rural Development, Chea Samnang.

Lien Aid was set up in 2006 to address the water and sanitation crisis in developing countries around Asia. A Singapore based non-governmental organisation, it was established as an independent entity through the Lien Foundation – Nanyang Technological University Environmental Endeavour.

Source: Anasuya Sanyal, Channelnewsaia.com, 13 Dec 2008 ; Lien Aid